The role of transcription factor Nrf2 in osteoarthritis

Introduction: L'arthrose est caractérisée par une destruction progressive du cartilage, une inflammation synoviale, et un remodelage de l’os sous-chondral avec une production excessive des médiateurs inflammatoires et cataboliques. Nous avons démontré que le niveau du 4-hydroxynonénal (4-HNE), un produit de la peroxydation lipidique, est augmenté dans le cartilage humain arthrosique sans qu’on sache le mécanisme exacte impliqué dans l’augmentation de cette molécule. Des données de la littérature indiquent que l’accumulation du HNE est contrôlée par l’action de la glutathione S-transférase A4-4 (GSTA4-4), une enzyme impliquée dans la détoxification du HNE. Au niveau transcriptionel, l’expression de cette enzyme est régulée par la transactivation du facteur de transcription Nrf2. Objectif: L’objectif de cette étude vise à démontrer que l’augmentation du HNE dans le cartilage arthrosique est attribuée, en partie, à l’altération de l’expression de la GSTA4-4 et de Nrf2. Méthode: Le niveau d’expression de la GSTA4-4 et de Nrf2 a été mesurée par Western blot et par PCR en temps réel dans le cartilage humain arthrosique et dans le cartilage provenant des souris atteintes d’arthrose. Pour démontrer le rôle du Nrf2 dans l’arthrose, les chondrocytes humains arthrosiques ont été traités par l’interleukine 1beta (IL-1β) ou par le H2O2 en présence ou en absence des activateurs du Nrf2 tels que le Protandim®, AI, et du 6-Gingérol. Par ailleurs, les chondrocytes ont été transfectés par un vecteur d’expression de Nrf2 puis traités par l’IL-β. En utilisant le modèle d’arthrose chez la souris, les animaux ont été traités par voie orale de 10 mg/kg/jour de Protandim® pendant 8 semaines. Résultats: Nous avons observé une diminution significative de l’expression de la GSTA4-4 et de Nrf2 dans le cartilage humain et murin arthrosique. L'activation de Nrf2 bloque la stimulation de la métalloprotéinase-13 (MMP-13), la prostaglandine E2 (PGE2) et de l'oxyde nitrique (NO) par l’IL-1β. En outre, nous avons montré que l'activation Nrf2 protège les cellules contre la mort cellulaire induite par H2O2. Fait intéressant, l'administration orale de Protandim® réduit la production du HNE par l'intermédiaire de l’activation de la GSTA4. Nous avons démontré que le niveau d’expression de la GSTA4-4 et de Nrf2 diminue dans le cartilage provenant des patients et des souris atteints d’arthrose. De plus, la surexpression de ce facteur nucléaire Nrf2 empêche la production du HNE et la MMP-13 et l’inactivation de la GSTA4-4. Dans notre modèle expérimental d’arthrose induite par déstabilisation du ménisque médial chez la souris, nous avons trouvé que l'administration orale de Protandim® à 10 mg / kg / jour réduit les lésions du cartilage. Conclusion: Cette étude est de la première pour démontrer le rôle physiopathologique du Nrf2 in vitro et in vivo. Nos résultats démontrent que l’activation du Nrf2 est essentielle afin de maintenir l’expression de la GSTA4-4 et de réduire le niveau du HNE. Le fait que les activateurs du Nrf2 abolissent la production de la HNE et aussi un certain nombre de facteurs connus pour être impliqués dans la pathogenèse de l’arthrose les rend des agents cliniquement utiles pour la prévention de la maladie.Background: Osteoarthritis (OA) is characterized by progressive cartilage destruction, synovial inflammation, and subchondral bone remodelling with increased inflammatory and catabolic responses. Elevated levels of oxidative stress lead to the accumulation of reactive oxygen species and subsequently the production of lipid-peroxidation products (LPO). The toxic aldehyde 4-hydroxynonenal (HNE) is a LPO product that was found, at pathological concentrations, strongly related to the release of different catabolic and inflammatory mediators in OA. Transcription factor nuclear factor erythroid 2-related factor 2 (Nrf2) acts as a key modulator for the expression of multiple cellular stress-response genes such as glutathione S-transferase A4-4 (GSTA4-4), an important HNE detoxifying enzyme. Protandim®, a commercial product composed of a mixture of natural antioxidant products is reported to activate and increase the levels of Nrf2 in different tissues. Objective: In this study we are evaluating the biological effects of Nrf2 activators such as, Protandim®, A-I, and 6-Gingerol. Results: The activation of Nrf2 can lead to indirect blockage of inflammatory and catabolic responses as well as oxidative stress. Using human OA chondrocytes, we demonstrated that Nrf2 activation by Protandim®, A-I, and 6-Gingerol abolished interleukin-1beta (IL-1β)-induced metalloproteinase-13 (MMP-13), prostaglandin E2 (PGE2), and nitric oxide (NO). Furthermore, we showed that Nrf2 activation protects cells against H2O2-induced cell death. Interestingly, the oral administration of Protandim® reduces HNE production via GSTA4-4 activation. We found that Nrf2 protein and mRNA levels decrease in OA cartilage from human and mice and match GSTA4-4 changes. Moreover, the overexpression of this nuclear factor abrogates IL-1β-induced GSTA4-4 inhibition as well as HNE and MMP-13 production. In our experimental mouse model of OA induced by surgical destabilization of the medial meniscus (DMM), we found that oral administration of Protandim® at 10 mg/kg/day reduces cartilage damage. Conclusion: This is the first in vitro and in vivo study to demonstrate the pathophysiological role of HNE in OA. In addition, this study indicates that Nrf2 activators abolish HNE production and number of factors known to be involved in OA pathogenesis. These findings render such activators clinically-valuable agents in the prevention of OA

Thymic Rejuvenation: Are We There Yet?

Vaccination is an appealing form of immunotherapy for frail senior patients. However, several studies have shown that in contrast to younger adults, older patients do not effectively respond to vaccines. This phenomenon is greatly attributed to immunosenescence, a hallmark of aging defined by a general decline in immunity caused by thymic involution. Historically, the study of thymic involution brought to attention several factors and components involved in thymopoiesis, as contributors to the phenomena. Depicting the underlying cause(s) of the dramatic changes in the production and properties of the naïve T-cell pool in the event of acute thymic injury or due to inovulation can therefore, help focus the efforts on the best strategy to reverse or overcome these hurdles. Here, we discuss some of the well-studied approaches for rejuvenating the thymus, and introduce interleukin-(IL) 21 as the most recent thymo-stimulatory agent in the field

Epidemiology of Chlamydia trachomatis in the Middle East and north Africa: a systematic review, meta-analysis, and meta-regression.

BACKGROUND: The epidemiology of Chlamydia trachomatis in the Middle East and north Africa is poorly understood. We aimed to provide a comprehensive epidemiological assessment of C trachomatis infection in the Middle East and north Africa. METHODS: We did a systematic review of C trachomatis infection as well as a meta-analysis and meta-regression of C trachomatis prevalence. We searched PubMed and Embase, as well as regional and national databases up to March 13, 2019, using broad search terms with no language or year restrictions. Any document or report including biological measures for C trachomatis prevalence or incidence was eligible for inclusion. We extracted all measures of current (genital or rectal), recent, and ever infection with C trachomatis. We estimated pooled average prevalence in different populations using random-effects meta-analysis. Factors associated with prevalence and sources of between-study heterogeneity were determined using meta-regression. FINDINGS: We identified a total of 1531 citations, of which 255 reports contributed to 552 C trachomatis prevalence measures from 20 countries. No incidence measures were identified. Pooled prevalence of current genital infection was 3·0% (95% CI 2·3-3·8) in general populations, 2·8% (1·0-5·2) in intermediate-risk populations, 13·2% (7·2-20·7) in female sex workers, 11·3% (9·0-13·7) in infertility clinic attendees, 12·4% (7·9-17·7) in women with miscarriage, 12·4% (9·4-15·7) in symptomatic women, and 17·4% (12·5-22·8) in symptomatic men. Pooled prevalence of current rectal infection was 7·7% (4·2-12·0) in men who have sex with men. Substantial between-study heterogeneity was found. Multivariable meta-regression explained 29·0% of variation. Population type was most strongly associated with prevalence. Additional associations were found with assay type, sample size, country, and sex, but not with sampling methodology or response rate (about 90% of studies used convenience sampling and >75% had unclear response rate). There was no evidence for temporal variation in prevalence between 1982 and 2018. INTERPRETATION: C trachomatis prevalence in the Middle East and north Africa is similar to other regions, but higher than expected given its sexually conservative norms. High prevalence in infertility clinic attendees and in women with miscarriage suggests a potential role for C trachomatis in poor reproductive health outcomes in this region. FUNDING: National Priorities Research Program from the Qatar National Research Fund (a member of Qatar Foundation)

Humoral Immunity to Allogeneic Immunoproteasome-Expressing Mesenchymal Stromal Cells Requires Efferocytosis by Endogenous Phagocytes

The extensive use of mesenchymal stromal cells (MSCs) over the last decade has revolutionized modern medicine. From the delivery of pharmacological proteins to regenerative medicine and immune modulation, these cells have proven to be highly pleiotropic and responsive to their surrounding environment. Nevertheless, their role in promoting inflammation has been fairly limited by the questionable use of interferon-gamma, as this approach has also been proven to enhance the cells’ immune-suppressive abilities. Alternatively, we have previously shown that de novo expression of the immunoproteasome (IPr) complex instills potent antigen cross-presentation capabilities in MSCs. Interestingly, these cells were found to express the major histocompatibility class (MHC) II protein, which prompted us to investigate their ability to stimulate humoral immunity. Using a series of in vivo studies, we found that administration of allogeneic ovalbumin (OVA)-pulsed MSC-IPr cells elicits a moderate antibody titer, which was further enhanced by the combined use of pro-inflammatory cytokines. The generated antibodies were functional as they blocked CD4 T-cell activation following their co-culture with OVA-pulsed MSC-IPr and mitigated E.G7 tumor growth in vivo. The therapeutic potency of MSC-IPr was, however, dependent on efferocytosis, as phagocyte depletion prior to vaccination abrogated MSC-IPr-induced humoral responses while promoting their survival in the host. In contrast, antibody-mediated neutralization of CD47, a potent “do not eat me signal”, enhanced antibody titer levels. These observations highlight the major role played by myeloid cells in supporting antibody production by MSC-IPr and suggest that the immune outcome is dictated by a net balance between efferocytosis-stimulating and -inhibiting signals

Covalent Binding of 4‑Hydroxynonenal to Matrix Metalloproteinase 13 Studied by Liquid Chromatography–Mass Spectrometry

Osteoarthritis (OA) is caused by the degradation of articular cartilage and affects approximately 80% of people over the age of 65. Matrix metalloproteinases (MMPs) belong to a group of zinc endopeptidases that degrade extracellular matrix (ECM) proteins in cartilage. MMP-13, also known as collagenase 3, cleaves type II collagen more rapidly than other MMPs and therefore is an important target for the treatment of OA. The lipid peroxidation product 4-hydroxy-2-(<i>E</i>)-nonenal (HNE), generated under oxidative stress, is known to play a crucial role in cartilage degradation; however, the mechanism is not yet fully understood. An approach has been developed to monitor HNE modification sites by incubating rhMMP-13 ± HNE <i>in vitro</i> followed by analysis of tryptic digests by UHPLC coupled to high resolution (HR) quadrupole-time-of-flight (QqTOF) tandem mass spectrometry (MS/MS). The analysis elucidated several covalently modified histidine and cysteine residues. The reaction was monitored using different HNE concentrations and incubation times. A targeted assay, using multiple-reaction monitoring (MRM), was then optimized to increase the sensitivity of detecting these modification sites in biological samples. HNE-related covalent modifications of MMP-13 were confirmed in enriched extracts from interleukin 1β-activated chondrocytes from OA patients using HR-MS/MS and MRM analysis

A1-reprogrammed mesenchymal stromal cells prime potent antitumoral responses

Summary: Mesenchymal stromal cells (MSCs) have been modified via genetic or pharmacological engineering into potent antigen-presenting cells-like capable of priming responding CD8 T cells. In this study, our screening of a variant library of Accum molecule revealed a molecule (A1) capable of eliciting antigen cross-presentation properties in MSCs. A1-reprogrammed MSCs (ARM) exhibited improved soluble antigen uptake and processing. Our comprehensive analysis, encompassing cross-presentation assays and molecular profiling, among other cellular investigations, elucidated A1’s impact on endosomal escape, reactive oxygen species production, and cytokine secretion. By evaluating ARM-based cellular vaccine in mouse models of lymphoma and melanoma, we observe significant therapeutic potency, particularly in allogeneic setting and in combination with anti-PD-1 immune checkpoint inhibitor. Overall, this study introduces a strong target for developing an antigen-adaptable vaccination platform, capable of synergizing with immune checkpoint blockers to trigger tumor regression, supporting further investigation of ARMs as an effective and versatile anti-cancer vaccine